| NPI | 1518072529 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME48521) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 128692) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 207RC0000X) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 48521) | |
| Enumeration Date | 2006-08-20 | 
| Last Update Date | 2023-09-08 |